Provider FAQs
We are radically different from our competitors. Our goal is not to be the largest network. Instead, our goal is to partner only with the best CAM providers who provide high quality, cost-effective care. Because of this distinction, we employ a unique health care management system that is based on trust and accountability. If you would like to learn more about our approach, here is a list of frequently asked questions (FAQ’s):
Credentialing
Why do you want me to be credentialed if you don't have contracts in my area?
We need a network in place in order to attract new clients. Your participation on our network helps to attract new business.
How do I join The CHP Group network?
You will have to fill out an application and go through a credentialing process which is compliant with the standards set by the National Committee for Quality Assurance (NCQA).
If you want to join The CHP Group network, please call email us at provider@chpgroup.com or call us in the Provider Services Department at (800) 449-9479 x501. We'd love to talk to you!
Will The CHP Group limit the number of providers in my area?
The CHP Group maintains the size of its network based on the requirements of its clients. If our clients want a large panel, we will recruit and process all applications we receive. However, if a smaller panel is needed, The CHP Group may deny applications based on geographic location alone.
How long will it take to become a CHP Group provider?
The application process takes 30-45 days from beginning to end, including submission to the Credentialing Committee. If you have already submitted an application to us and want to check the status, please feel free to contact us via email at providers@chpgroup.com or call us in the Provider Services Department at (800) 449-9479 x501.
Will I have to fill out more credentialing paperwork later? Become recredentialed?
The CHP Group, and many of our health plan partners, adhere to the standards set by the National Committee for Quality Assurance (NCQA). These standards require providers to be reviewed every two or three years. In order for us to comply with this requirement we will be in contact with you but will make the process as easy as possible since we will already have much of your information on file.
Fees
Are there any fees to join?
No. There are no fees to join the network.
Are there any fees charged on an ongoing basis?
There are no administrative fees, withholds, per claim fees, or other charges for participation with CHP, at this time – nor do we anticipate any. However, as health care continues to evolve, we cannot in all honesty say this will never occur. If we do have to initiate some charges in the future, each provider will have to sign a contract amendment acknowledging and accepting the fees, whatever they might be. If you don’t agree, the contract can be terminated at your discretion.
What is the fee schedule for my area?
Each fee schedule is determined by the health plan (or other payer) with input from The CHP Group. All fee schedules are reviewed annually and any changes are mailed to the network with 30-60 days advanced notice. Each provider then has those 30-60 days to decide whether or not they wish to continue participation.
A sample fee schedule may be available if there are no contracts currently operating for your area, however, it will only be a sample as fee schedules are generally negotiated in the final stages of a new contract.
Contracts/Business
Will The CHP Group have new business in my area?
Yes, we have sales people working to develop business with health plans, employer groups, and various types of associations.
What type of contracts does The CHP Group anticipate?
We generally contract for commercial health contracts. These plans are usually sold with medical plans and allow members direct access to CHP panel providers with applicable copayments, coinsurance, deductibles, etc.
Are medical referrals required?
Most of The CHP Group’s programs do not require medical referrals. Our vision of the future is one where patients can freely choose the best health care options for themselves and this is best achieved through direct access plans.
Are pre-approval forms required prior to treatment?
There are no forms required prior to treatment for any current plans nor is that the way The CHP Group likes to do business.
There are some high level E&M codes or other situations where a request for chart notes may be made but the expectation is each provider’s chart notes will substantiate the treatment being given at each visit.
There is one current plan which requires a “Treatment Extension Request” after the first 12 visits but does not have to be submitted if the chart notes contain all of the required information documenting the need for continuing care.